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Building Permit Application
All APPLIC BL((E pp1 FO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �1J1 ( Permit Number: "l0 7q ' Q 4 �� Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772).462-1578 Commercial Residential PERMITTYPE: a PRQ�POS,ED IIVIt�ROVEMEN.a,La.CAT10N. ,• x s Address: 0 RID[ liW-Q u tl Property Tax ID#: o Ol`l J�D I — I l(� 0 1 Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION O WORK k : m Q CONSTRUCTION N INFORMATIt7 a w . ., ..... . i Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: o Sq. Ft.of First Floor: 00 Cost of Construction:$ 0 1 o• Utilities: —Sewer _Septic Building Height: i OWNERfLE 'SEE ;a �CaNTRAC" Name Name: Address:© 'L Company: City: o Stat Addr..ess: - Zip Codei �^ Fax: City '` State: Phone No ZipCode: E-Mail: n Phone No "k Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.